I Excel of North Carolina LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

171324 Issued in NC

Legal business name

I EXCEL OF NORTH CAROLINA LLC

Practice address

4822 Albemarle Rd
106
Charlotte, NC 28205-6668

Phone

(704) 293-4780

Fax

(704) 419-1936

NPI assigned

Aug 11, 2009

Last updated

Aug 11, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Samuel Matthew Evans

Title

Owner

Phone

(704) 293-4780

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1249948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1249948800000",
    "number": "1205068228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4822 ALBEMARLE RD",
            "address_2": "106",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282056668",
            "telephone_number": "704-293-4780",
            "fax_number": "704-419-1936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4822 ALBEMARLE RD",
            "address_2": "106",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282056668",
            "telephone_number": "704-293-4780",
            "fax_number": "704-419-1936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "I EXCEL OF NORTH CAROLINA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-11",
        "last_updated": "2009-08-11",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "MATTHEW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-293-4780"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "171324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.